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Caffeine, Your Baby, and You

Yesterday's Health section featured a refreshing article by a 6-months-pregnant woman grappling with the baffling array of dietary decisions a good mom's supposed to make in these nutrition-conscious days.

Writer Moira E. McLaughlin discussed her dismay at having to do without beer ("Ah, delicious summer brews! Sweet Octoberfests! Thick winter stouts!"), sushi, and blue cheese in the current cautious climate, so different from the one in which many of our own smoking, drinking mothers enjoyed when they were bearing us and our siblings.

The article mentioned caffeine only in passing. But the question of whether caffeine's safe for pregnant women and their babies continues to be examined by experts and pregnant women alike. Many experts concur that cutting caffeine altogether is the safest bet for protecting an unborn baby's health, as its consumption may increase the risk of miscarriage, a suspicion supported by research released in January.

In light of that research, the March of Dimes recommended that if a pregnant mother must have her daily hit, she limit herself to no more than 200 mg a day -- about 12 ounces of coffee's worth.

(Curious about how much caffeine you're consuming? Check this list from the Center for Science in the Public Interest, a consumer advocacy group that's been pushing the FDA to require food and beverage labels to list caffeine content.)

And now this: a study published online Monday in the British Medical Journal showed that the more coffee a pregnant woman drinks, the greater the risk of her baby's being born underweight. The association held even for those who consumed very little caffeine, less than you'd get from that single cup of coffee per day, and grew stronger with increased consumption.

In general, a certain amount of caffeine has some benefits. A study published in June in the Annals of Internal Medicine showed that consuming coffee may well offer modest protection against cardiovascular disease. Caffeine intake has also been linked to reduced risk of some forms of dementia. They keep testing caffeine consumption against different diseases, such as breast cancer, but don't seem to find many links pro or con.

But the stakes are different when you're a pregnant woman; you have to weigh whatever potential benefit to your own health caffeine might offer against the risks it might pose to your baby. What's a thinking -- or an over-thinking -- mom to do?

When I was pregnant with each of my two kids, I went cold turkey on caffeine, cutting back from several cups a day to none whatsoever. It wasn't easy: I remember many a foggy-headed morning and headachy afternoon. Looking back, I wonder whether I could have safely indulged in a daily cup of joe, but at the time it simply didn't seem worth the risk, however small.

Current moms, did you consume caffeine while pregnant? To any ill effect? And moms-in-the-making, how are you sorting out all the nutrition information, including that about caffeine, that's strewn in your path?

By Jennifer LaRue Huget  |  November 5, 2008; 7:00 AM ET
Categories:  General Health  
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I'm 4 months pregnant, and after a talk with my dr, came to the conclusion that you can live in fear, or live with common sense.

Yesterday's article was a boon to the fearmongers - you can eat cooked sushi or vegetarian sushi. You can eat deli meats, as long as they are heated to the point of steaming - 30 seconds in the microwave, or the occasional "toasted sandwich" like at Quizno's. You can eat soft cheese, as long as it's made with pasteurized milk. And most is. You can eat hot dogs, but they must be very well cooked. All of this may mean you ask more questions at a restaurant, or choose to confine some foods to home preparation instead of ordering them while out and about, but you don't have to give them up for 9 months.

Caffeine isn't an issue for me, as I gave it up 15 years ago for other reasons. So the only caffeine I get comes from chocolate, and I'm not willing to give that up. But I go back to the common sense vs. fear. Going cold turkey isn't really good for your health, if you're accustomed to a lot of caffeine. And why add to the things that make you feel poorly in the first trimester. Yes, work on reducing the caffeine intake. Be smart about your nutrition. But letting research studies stress you out can also increase your risk of a miscarriage, and doesn't make sense to me.

Posted by: JHBVA | November 5, 2008 9:58 AM | Report abuse

I cut back on caffeine when I was pregnant, but I didn't eliminate it completely. I had probably less than a cup a day. It was just enough to give me a little boost in the morning. Pregnancy and baby was absolutely not effected by it. I'm still mostly caffeine free as I'm breast feeding. Definitely looking forward to having a full cup of regular coffee one day soon!

Posted by: DCMainer | November 5, 2008 10:03 AM | Report abuse

I had no caffeine with kid number one--maybe a coke or two at the most. Now I'm halfway through my second pregnancy and I do drink iced tea from time to time, but we've stopped eating out for the most part so it's easy to make decaf at home. I've never been a coffee drinker, so no issues there.

I do still eat blue cheese, I heat up deli meat in a skillet before putting it on my sandwich, and enjoyed a corn dog at Disney last week.

Posted by: MPAmom | November 5, 2008 11:36 AM | Report abuse

I naturally cut back on caffeine with both kids at first; I was so sick during the first 4-5 months that I could barely keep water down, and my normal iced tea was on the list of things that Just Didn't Sound Good. Once I started feeling better, I added some back in (especially with the second), but it was later in the pregnancy and so not so much to worry about.

But I'm also just not much of an absolutist. Being pregnant is such an overwhelming, important thing; you want that baby to be healthy more than anything in the world, and yet being pregnancy makes you more aware of all those dangers out there that you can't control. The guy next to me just coughed; does he have some undiagnosed disease? Does my baby have some chromosomal defect that we don't know about? I think we focus so much on healthy eating as a way of trying to feel in control in the face of all of this uncontrollable scary -- I can't control whether I get hit by a car, but dangit, I can keep my baby nitrite-free. It's an anodyne against the Big Bad Scary.

I don't know, maybe that's just me. See, I did everything "right" my whole life, and still lost three pregnancies. Makes you realize that there are no guarantees, and that the huge, vast majority of bad stuff is completely out of your hands. So why drive yourself absolutely nuts fixating on every conceivable iota of risk that remains? There's no such thing as perfect. Talk to your doctor, make your own judgments, and ignore the hysteria.

Posted by: laura33 | November 5, 2008 12:39 PM | Report abuse

I like a cup of coffee in the morning, but while I was pregnant I changed to a cup of tea instead (not a huge difference in caffine).

And one thing I find interesting, is that yesterday, no one mentioned organic hotdogs. They have no nitrites and are also the "healthiest" hotdogs around. So, if you want a hotdog and are worried about it, just eat a properly cooked organic hotdog.

Posted by: willowonyx | November 5, 2008 1:19 PM | Report abuse

Okay, a few weeks ago, we found out that our drinking water has rocket fuel in it, unsafe levels of it. Enough that it could be measured in breastmilk and newborns. Why doesn't the Post revisit that? Are we supposed to stop drinking water? What about the rain? Researchers found that states that receive more rain see more births of Autistic children. Are we supposed to move?

Stop guilting new mothers with the whole coffee, hot dog thing already. Sheesh! Also, what about fathers? Are men allowed to eat, drink, do drugs, smoke and then be expected to produce 100% healthy sperm? What are the Dads supposed to give up or do to ensure a healthy pregnancy?

To be honest, nobody should swig coffee or eat hot dogs everyday, and many women kick the junk food habit when they try to get pregnant. So trying to add the the already long list of fears of things you have to worry about causes stress - you know that thing you're not supposed to do when you're pregnant.

How many women have lost their babies or had their babies born with some condition and they sit around punishing themselves for a hot dog or a few cups of coffee they craved? Let's look to the Environmental Protection Agency to start doing their job so at least we know we can still enjoy a glass of water.

Posted by: catweasel3 | November 6, 2008 7:32 AM | Report abuse

I still drank coffee, but tried to limit my afternoon drinks to non-caffinated only. I really tried to stay away from artificial sweetners and junk, and that's about it. I honestly think that you can overthink your choices so much you worry yourself sick.

And, catweasel3, sorry about the decision re: percholorate (rocket fuel). I'm one of the people on the State level charged with cleaning up environmental contamination, and you can imagine my dismay when the EPA declined to set a limit on percholrate in drinking water. Buy bottled water for now and call your state environmental agency or health department to find out what they recommend you do. Good luck.

Posted by: Mazarin | November 6, 2008 11:58 AM | Report abuse

I gave up caffeine (Diet Coke), deli meat, soft cheese, uncooked sushi, limited my fish intake, and avoided anything with aspartame while pregnant. I figured that I wanted to be above reproach should anything happen to the baby. Admittedly, all sorts of things could still have happened, but I wanted to do my best to avoid those things. I missed sushi every single day of those 9 months.

Posted by: Laura118 | November 12, 2008 11:32 AM | Report abuse

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